- Houston Methodist (The Woodlands, TX)
- …needs for the department and the hospital. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and resource use, ... for the hospital. + Secures reimbursement for hospital services by communicating medical information required by all external review entities, managed care… more
- Fresenius Medical Center (Olmito, TX)
- …any governmental or regulatory body having jurisdiction in the premises. Assists the Medical Staff to ensure that medical practices and procedures meets ... Safety Code + Plan personnel, equipment, and medications needed for medical emergencies; incorporate into Emergency Preparedness Plan; ensure maintenance of… more
- Houston Methodist (Houston, TX)
- …for employee engagement, ie peer-to-peer accountability. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and ... for the hospital. + Secures reimbursement for hospital services by communicating medical information required by all external review entities, managed care… more
- Humana (Austin, TX)
- …focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with health ... The Corporate Medical Director (CMD) relies on medical background to review health claims and...10-hour workdays per week, either Friday-Monday or Thursday-Sunday schedule. Travel : While this is a remote position, occasional … more
- Fresenius Medical Center (Houston, TX)
- …communicated to and implemented by the facility staff. + Maintains integrity of medical records and other FMS administrative and operational records. + Complies with ... renal team. Communicates changes in patient status regarding clinical, insurance, travel and transportation issues to the disease management company. Maintains… more
- Houston Methodist (Houston, TX)
- …many of the following: organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of staff performance, ... and prioritize daily tasks. Provides leadership to staff on efficient utilization of time according to budgetary guidelines. Reviews team member's timecards… more
- Humana (Austin, TX)
- …focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with health ... part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The Corporate… more
- CVS Health (Arlington, TX)
- …Field Experience. + Bilingual. + Crisis intervention skills preferred. + Managed care/ utilization review experience preferred. + Case management and discharge ... Manager Behavioral Health** **Position Summary** This is a remote role, requiring 75% travel to meet in-person with members around our service delivery area. The… more
- Fresenius Medical Center (Plano, TX)
- …coding. + Chart Analysis, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses ... and procedures. Adheres to Standards of Ethical Coding (AHIMA/AAPC). Reviews medical records for the determination of accurate assignment of all documented diagnoses… more
- Merck (Austin, TX)
- …Trial Planning, Communication, Decision Making, Empathy, Market Access, Medical Affairs, Medical Research, Medical Review , Medical Writing, Patient ... **Job Description** **Role Summary:** The Sr. Global Director Medical Affairs (GDMA) is responsible for supporting the execution of scientific & medical affairs… more